MEDICARE: CHRISTINA ROCK MOT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	15701	FL

General Provider Information

NPI Number	:	1750624631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA ROCK MOT

Provider Business Mailing Address
First Line	:	711 S HAMPTON AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-6517
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	453 N KIRKMAN RD
Second Line	:	SUITE 104
City	:	ORLANDO
State	:	FL
Zip	:	32811-1109
Country	:	US
Telephone Number	:	407-293-3156
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2013
Last Update Date	:	03/29/2013

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Directions to “ CHRISTINA ROCK MOT” Practice Location

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